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Trial registered on ANZCTR
Registration number
ACTRN12617000487314
Ethics application status
Approved
Date submitted
28/03/2017
Date registered
4/04/2017
Date last updated
10/07/2019
Date data sharing statement initially provided
10/07/2019
Type of registration
Prospectively registered
Titles & IDs
Public title
Theta Burst Stimulation in fibromyalgia
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Scientific title
A double-blind randomized sham-controlled trial to evaluate the effect of prefrontal Theta Burst Stimulation on severity and impact of pain in patients with fibromyalgia
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Secondary ID [1]
291109
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Nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Fibromyalgia
301936
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Condition category
Condition code
Musculoskeletal
301589
301589
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0
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Other muscular and skeletal disorders
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Neurological
302241
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0
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Other neurological disorders
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Theta Burst Stimulation (TBS).
Participants will undergo 32 treatment sessions across 4 weeks administered by a research nurse. Each TBS procedure will take approximately 3 minutes and you will complete two TBS treatments at each visit (total of 6 minutes of TBS treatment per visit, 15 minutes between each treatment). During the initial two weeks of treatment, participants will attend daily (Monday-Friday) treatment. During the final two weeks of treatment, participants will attend treatment on Mondays, Wednesdays and Fridays only.
TBS will be administered with a NeuroSoft-MS/D or Magventure Magpro magnetic stimulator using a figure-of-8 coil, dependent on patient scheduling. Prior to the commencement of rTMS treatment, single pulse TMS will be used to measure the resting motor thresholds (RMT) in all subjects using standard methods. The RMT is used to determine the intensity of the rTMS treatment and is a means of tailoring the stimulus intensity for each participant.
Participants will be randomly allocated to receive either active or sham TBS via a computer generated sequence by a study investigator who is not involved in treatment or assessment. In active TBS treatment, participants will receive 3-pulse 50Hz bursts applied at 5Hz. Stimulation intensity will be set at up to 120% RMT and will be applied to the left dorsolateral prefrontal cortex.
To assess fidelity of blinding we will be conducting blinding questionnaires with participants at the end of their treatment..The above protocol is in compliance with current published TBS safety guidelines.
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Intervention code [1]
297098
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Treatment: Devices
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Comparator / control treatment
Participants allocated to the sham condition will be administered sham TBS that will be identical to the active condition (described above) except no stimulation will be applied.
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Control group
Placebo
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Outcomes
Primary outcome [1]
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Change in severity and impact of pain as measured by the Brief Pain Inventory (Short-form).
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Assessment method [1]
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Timepoint [1]
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Baseline versus 4 weeks versus 8 weeks
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Primary outcome [2]
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Multifaceted Fatigue Inventory
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Assessment method [2]
302691
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Timepoint [2]
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [1]
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A Numerical Pain Rating Scale of pain intensity and pain unpleasantness (NPRS 0-10)
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Assessment method [1]
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Timepoint [1]
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [2]
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Short-Form McGill Pain Questionnaire
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Assessment method [2]
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Timepoint [2]
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [3]
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Self-reported health assessed by Short-Form 36 Version 2
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Assessment method [3]
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Timepoint [3]
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [4]
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Fibromyalgia Impact Questionnaire
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Assessment method [4]
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Timepoint [4]
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [5]
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Beck Depression Inventory-II
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Assessment method [5]
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Timepoint [5]
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [6]
331365
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Beck Anxiety Inventory
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Assessment method [6]
331365
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Timepoint [6]
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [7]
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State-Trait Anxiety Index
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Assessment method [7]
331366
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Timepoint [7]
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [8]
331367
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Multifaceted Fatigue Inventory
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Assessment method [8]
331367
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Timepoint [8]
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [9]
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Pain Catastrophisation Index
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Assessment method [9]
331368
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Timepoint [9]
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [10]
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Depression, Anxiety, and Stress Scale 21
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Assessment method [10]
331369
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Timepoint [10]
331369
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [11]
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Posttraumatic Stress Disorder Checklist
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Assessment method [11]
331370
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Timepoint [11]
331370
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [12]
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Medical Outcomes Study Sleep Outcomes
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Assessment method [12]
331371
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Timepoint [12]
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [13]
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Pittsburg Sleep Quality Index
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Assessment method [13]
331372
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Timepoint [13]
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [14]
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Pain Self-Efficacy Questionnaire
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Assessment method [14]
331373
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Timepoint [14]
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [15]
331374
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Pain Vigilance and Awareness Scale
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Assessment method [15]
331374
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Timepoint [15]
331374
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [16]
331375
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Pain Anxiety Symptom Scale
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Assessment method [16]
331375
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Timepoint [16]
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [17]
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Pain Beliefs and Perceptions Inventory
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Assessment method [17]
331376
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Timepoint [17]
331376
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [18]
331377
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Adverse Events will be recorded via self report. This may include head-ache or neck-ache, and, although very unlikely, seizure.
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Assessment method [18]
331377
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Timepoint [18]
331377
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [19]
331380
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Patient Global Impression of Change
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Assessment method [19]
331380
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Timepoint [19]
331380
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End of treatment course (week 4) and 8 weeks
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Secondary outcome [20]
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Cortical function via Transcranial magnetic stimulation (TMS) with concurrent electroencephalogram (EEG) recording (TMS-EEG)
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Assessment method [20]
333243
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Timepoint [20]
333243
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Baseline versus 4 weeks versus 8 weeks
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Secondary outcome [21]
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Childhood Trauma Questionnaire (CTQ) and the Life Events Checklist (LEC)
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Assessment method [21]
336761
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Timepoint [21]
336761
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Baseline vs 4 weeks vs 8 weeks
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Eligibility
Key inclusion criteria
Inclusion Criteria: patients will be included if they:
- have a current diagnosis of fibromyalgia
- aged between 18 and 75 years
- have had no increase or initiation of new medication therapy in the four weeks prior to study screen
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Minimum age
18
Years
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Maximum age
75
Years
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Exclusion Criteria: Participants who:
- Patients who have an unstable medical condition, neurological disorder or any history of seizure disorder or are currently pregnant or lactating
- The presence of metal anywhere in the head, except the mouth, which may interfere with the magnetic field
- Have a current DSM-V diagnosis of Substance Abuse or Dependence disorder, or another psychiatric condition. This excludes depression, PTSD or anxiety unless they are the primary disorder (i.e. fibromyalgia is not the primary disorder).
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Study design
Purpose of the study
Treatment
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Allocation to intervention
Randomised controlled trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
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Masking / blinding
Blinded (masking used)
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Who is / are masked / blinded?
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Intervention assignment
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Other design features
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Phase
Phase 2
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Type of endpoint/s
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Statistical methods / analysis
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Recruitment
Recruitment status
Active, not recruiting
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Date of first participant enrolment
Anticipated
1/05/2017
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Actual
15/06/2017
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Date of last participant enrolment
Anticipated
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Actual
2/07/2019
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Date of last data collection
Anticipated
31/12/2019
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Actual
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Sample size
Target
52
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Accrual to date
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Final
40
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Recruitment in Australia
Recruitment state(s)
VIC
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Funding & Sponsors
Funding source category [1]
295550
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University
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Name [1]
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Monash University
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Address [1]
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Monash Alfred Psychiatry Research Center,
Level 4, 607 St Kilda Road
Melbourne 3004 VIC
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Country [1]
295550
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Australia
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Primary sponsor type
Individual
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Name
Dr Bernadette Fitzgibbon
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Address
Monash Alfred Psychiatry Research Center,
Level 4, 607 St Kilda Road
Melbourne 3004 VIC
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Country
Australia
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Secondary sponsor category [1]
294372
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None
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Name [1]
294372
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Address [1]
294372
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Country [1]
294372
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
296870
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Alfred Health Ethics Committee
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Ethics committee address [1]
296870
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55 Commercial Rd, Melbourne VIC 3004
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Ethics committee country [1]
296870
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Australia
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Date submitted for ethics approval [1]
296870
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01/02/2017
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Approval date [1]
296870
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23/03/2017
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Ethics approval number [1]
296870
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33/17
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Ethics committee name [2]
297352
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Monash Ethics
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Ethics committee address [2]
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Monash Research Office. Monash Research Office Chancellery Building D 26 Sports Walk Monash University, Clayton, Victoria 3800.
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Ethics committee country [2]
297352
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Australia
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Date submitted for ethics approval [2]
297352
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30/03/2017
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Approval date [2]
297352
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30/03/2017
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Ethics approval number [2]
297352
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8790
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Summary
Brief summary
The proposed study aims to conduct a double-blind, randomized, sham-controlled proof of principle trial to establish the efficacy of Theta Burst Stimulation (TBS) treatment in fibromyalgia. Fibromyalgia and related disorders present a substantial health problem, with current treatments limited in their efficacy and associated with a number of side effects. This study will explore for the first time in fibromyalgia a novel non-pharmaceutical intervention, TBS; a non-invasive brain stimulation method. TBS is a powerful new alternative to standard non-invasive brain stimulation methods as it can be applied in a much more time efficient manner and may result in greater clinical benefit. If successful, the application of this method for fibromyalgia may be applicable to related disorders such as Chronic Fatigue Syndrome. This is a randomised sham-controlled trial study, in which 52 participants with a diagnosis of fibromyalgia will be recruited. Participants will be randomised into one of two conditions- (1) Active TBS condition and (2) Sham (or ‘placebo’) TBS condition. Participants will have two weeks of twice daily stimulation followed by a tapered two week dose of twice daily treatments on Monday, Wednesday and Friday only. Participants will be asked to a number of self-report questionnaires at baseline, at the end of each treatment week (weeks 1-4) and at the 1 month follow up appointment, as well as will undergo the collection of neurobiological data (TMS-EEG) at baseline, end of week 4 and follow-up.
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Trial website
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Trial related presentations / publications
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Public notes
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Contacts
Principal investigator
Name
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Dr Bernadette Fitzgibbon
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Address
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Monash Alfred Psychiatry Research Centre
Level 4, 607 St Kilda Road
Melbourne VIC 3004
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Country
72286
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Australia
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Phone
72286
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+61 3 9076 9860
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Fax
72286
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Email
72286
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[email protected]
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Contact person for public queries
Name
72287
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Bernadette Fitzgibbon
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Address
72287
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Monash Alfred Psychiatry Research Centre
Level 4, 607 St Kilda Road
Melbourne VIC 3004
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Country
72287
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Australia
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Phone
72287
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+61 3 9076 9860
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Fax
72287
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Email
72287
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[email protected]
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Contact person for scientific queries
Name
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Bernadette Fitzgibbon
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Address
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Monash Alfred Psychiatry Research Centre
Level 4, 607 St Kilda Road
Melbourne VIC 3004
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Country
72288
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Australia
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Phone
72288
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+61 3 9076 9860
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Fax
72288
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Email
72288
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[email protected]
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Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
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No/undecided IPD sharing reason/comment
We do not have ethical approval to share patient data.
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What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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